Provider Demographics
NPI:1679465124
Name:JESSIE LOUIS-JEAN, MS, LMHC
Entity type:Organization
Organization Name:JESSIE LOUIS-JEAN, MS, LMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOUIS JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:646-856-9151
Mailing Address - Street 1:1383 PETERS BLVD
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-4847
Mailing Address - Country:US
Mailing Address - Phone:646-856-9151
Mailing Address - Fax:631-614-5642
Practice Address - Street 1:28 E OLD COUNTRY RD STE 6
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-4292
Practice Address - Country:US
Practice Address - Phone:646-856-9151
Practice Address - Fax:631-614-5642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health